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CITY OF SOUTH BEND, INDIANA�, <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME 315 & 319 W. Jefferson Exterior Renovations Division C' <br />PROJECT NO 119-064 FINAL COST $43,075.00 <br />CONTRACT SIGNED 8/27/2019 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Parking lot retLairs and curb & sidewalk re aLacement at 315 & 319 W. Jefferson Blvd. <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having been completed, <br />the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or <br />by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City <br />of South Bend wWoRwere 4 part of the above Contract. <br />xecute t is 8th tlay of Se 1',C her , 2ox _ 20 Walsh & Kell , Inc. <br />Company Name <br />W� tug a 24358 State Road 23 <br />ustin Hi <br />South Bend Area Vice President Company Address <br />.......� _ <br />Printed Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally a eared <br />the 8th <br />y d acknowledged his/her si � er,,,� f/ r�ota�y Public,Tip of indi,3 le ion Affidavit on <br />IS a - d, of r jr an r ��, 20%K�0. <br />St. Joseph County <br />r'' <br />2(22 <br />Notary S' d My Comm <br />otaiss;on E spires <br />e Mir Gbmrrai�`sion 2022 <br />Alisha Krueger <br />Printed Name <br />County of Residence St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />1, Jamie L. Tancos <br />certify that I am Secretary of the Corporation executing this release; that <br />SOuth B �I <br />Bend Area Vice President <br />_.�._.. -.._ m who signed this release on behalf of the contractor wa��t, 00. 4t1411, e <br />of said Corporation; that said release was duly signed for and p i& CK� <br />Corporation by Authority of its governing body, and is within the scope of corporate powers: �.`� �,,..• /� <br />r` G©�PQN,gll�. <br />........... _......... _..... ._ _...-.._............... �.................. <br />Secretary's Signature <br />_ _ t<` � C) _ <br />s • S ale Seal <br />Jamie L. Tancos <br />, <br />�A, •••�•'' <br />Printed Name <br />••• •••'' �� <br />'''.1 <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: 09/14/2020 <br />Constructiob'Manager <br />BOARD OF PUBLIC WORKS <br />Gary A. Gilot, President <br />^ <br />Elizabeth A Maradik, Member <br />Joseph R. Molnar, Member <br />BOARD OF PUBLIC WORKS APPROVAL Date: September 22, 2020 <br />']heresc .1. Dormr, hlembcr <br />Jordan V. Oathers, Member <br />ATTEST <br />sZv" ! C, 1Nw r/ <br />Lin M. Marhn, C;lcrlc...... <br />